From Abracadabra to Zombies

Amen, Daniel, M.D.

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mass media treatment of issues concerning science, the
paranormal, and the supernatural.

PBS Infomercial for Daniel Amen's Clinics

...it is not possible to
definitively determine whether a person is anxious or feeling
connected simply by looking at activity in a particular brain
region. This is so because brain regions are typically engaged
by many mental states, and thus a one-to-one mapping between a
brain region and a mental state is not possible.*

The notion that we can use
cortical maps to improve our lives—romantically, politically, or
otherwise—forms the basis for Amen's business empire. --Daniel
Engber

January 1, 2009. I rarely watch
television news these days, but the recent missile attacks by
Hamas on Israeli civilians aroused my curiosity enough to
want to hear what the PBS folks had to say about the attacks and
the Israeli response. When the experts finished explaining why Israel does
this or that, and how Iran and Syria do this or that, and how
"emboldened" Hamas has become, I continued to sit on the
couch, sipping a glass of inexpensive red wine. Before I knew it,
I was watching "Magnificent Mind at Any Age with Dr. Daniel
Amen." After watching for about five minutes, I said to my wife,
"this is like an infomercial for this guy's clinics." Then Dr.
Amen started telling his audience, whoever they might be
(friends and family? hired actors?), about
the wonders of
ginkgo and other "natural" products
such as St.
John's wort. Wait a
minute. I've read about the latest studies on ginkgo and St.
John's wort. This guy
is still claiming that ginkgo helps with memory and with
preventing dementia, and that St. John's wort helps with
depression. The most recent scientific studies have
found neither of these claims to be true. I've followed the
argument that favors natural over synthetic supplements, too: there's
no proven superiority of the one over the other. More important:
there's no compelling evidence that taking
supplements is beneficial for most
people. (It is probably true, though, that there are fewer
dangerous side-effects from supplements than from potent
pharmaceuticals and that if one could get the same benefit from
a "natural" supplement as from a strong pharmaceutical, one
should choose the supplement because it's probably cheaper and
safer. But how often is that the case? Probably never. If the
nutraceutical is as good as the pharmaceutical it probably has
the same chemicals and would produce the same side effects.)

Early in his
infomercial, Dr. Amen touted his use of SPECT (single
photon emission computed tomography), a process that
involves injecting the patient with radioactive dye and uses
software that converts pictures of blood flow to parts of the
brain into three-dimensional, colored images. Most SPECT images
I've seen look like this:

Amen's software
produces some strange pictures. Here is an example:

You can view rotating
SPECT images on his website. Click
here to view an image of a "brain on drugs."

On his PBS
infomercial, Amen showed some slides of
(non-rotating) brains that had been morphed by software to produce "holes"
where little or no blood was detected flowing. He showed slides
of what he said were diseased brains and healthy brains. He told
his audience that these SPECT images helped him diagnose all
kinds of things. He said he's done thousands of them. I suppose
we were to infer that he must know what he's talking about.

Scientists are
reading an awful lot into brain scans these days, and much of
what they are seeing may have originated in their own brains,
confirming their biases. I had to wonder: is Dr. Amen ahead of
the curve or another self-deceived promoter of quackery.

I
wasn't fifteen minutes into this program before I was asking myself:
why is this on PBS? I paused the program, thanks to TiVo, and
did some googling before returning to the TV to find that Amen was
live in the studio of my local PBS station. This was fundraising
night and this "great show" was just one of the many "great
programs" KVIE brings to its Sacramento area audience throughout
the year. And weren't we lucky to have the great man himself in
the studio to promote his own program! Yes, it turns out that
Amen produced the program and it really was an infomercial,
though it was not billed as such. No PBS station anywhere had
anything to do with the production of Amen's program. This guy
is no dummy.

PBS, on the other
hand, looks like a dummy to me. It is because of programs that
feature snake oil salesmen and purveyors of woo that I no longer
support public television. I don't care if a station puts on an
infomercial, but I care if my tax dollars are used to make the
infomercial available to a large television audience. Why should
the taxpayer subsidize these programs? And why do we let PBS get
away with the ruse of "underwritten by" or "with support from"
when these are just paid advertisements by another name? Anyway,
Amen, Wayne Dyer, Suze Orman, Andrew Weil, and others of like
ilk might draw in PBS
subscribers, but they make my resistance even stronger. Make
these folks pay for the infomercials for their books and
products like advertisers do on commercial television.

What I found by
googling Amen was that he's a psychiatrist who is promoting
ideas about keeping the brain healthy and improving mental
functioning. Most of his ideas are either so well known as to be
considered common sense or they are notions that don't have much
scientific backing. He recommends that we exercise, both
physically and mentally, that we not smoke or drink alcohol to
excess, that we eat well, and that we do what we can to control
the stress in our lives. Nothing new here. But then he suggests
that these modest proposals joined with taking supplements,
which he just happens to sell from his
website store,
can ward off or halt Alzheimer's, among other things. You won't
find too many scientists agreeing with that hopeful claim. I
have been following the news on
supplements for the past fifteen years and the bulk of the
evidence strongly indicates that there is no benefit to most
people from taking supplements unless they are specifically
called for because of a known deficiency. My mother, who was a
registered nurse, wasted a lot of money on vitamin C
tabs for our family. At the first sign of a cold, my sisters and
I were like trained seals and headed for the vitamin C jar.

On his website, Amen
says:

Amen Clinics is
dedicated to improving the lives of every family we serve
through education, the latest advances in neuroimaging, and
individualized treatment plans. We believe in using the least
toxic, most effective treatments for our patients, and use a
variety of interventions from natural supplements, medications,
dietary interventions and targeted forms of psychotherapy.

Amen Clinics Inc.
specializes in brain health and innovative diagnosis and
treatment for a wide variety of neuropsychiatric, behavioral and
learning problems among children, teenagers and adults.
Established in 1989 by Daniel G. Amen, M.D., the center has a
national reputation for utilizing brain SPECT imaging for a wide
variety of neuropsychiatric problems, including ADD, anxiety,
depression, autism and memory problems.

Who wouldn't want the
least toxic treatment? Are other doctors giving their patients
toxic drugs when natural supplements with no adverse side
effects would serve them just as
well? That seems to be the implication, though it's absurd. Using SPECT might be
innovative, but is it as useful as Dr. Amen claims?

In a book he
co-authored in 2004, Amen says: "Through prevention strategies,
you may be able to delay the onset of Alzheimer's long enough so
that you will never have symptoms." One of the prevention
strategies is early detection, for which Amen recommends SPECT.
For prevention, he recommends various supplements. His is a
rather extravagant claim, likely to give hope but rather
questionable. In an
article in Salon.com that is very critical of Dr. Amen,
Robert Burton, M.D.,
writes:

"SPECT scans are not
sufficiently sensitive or specific to be useful in the diagnosis
of A.D. [Alzheimer's disease]," neurologist
Michael Greicius, who runs the Stanford University memory
clinic, and has a special interest in the use of functional
brain imaging in the diagnosis of A.D., tells me. "The PBS
airing of Amen's program provides a stamp of scientific validity
to work which has no scientific validity."

Burton also
castigates Amen for his
supplement recommendations for the prevention of
Alzheimer's. The recommendations seem based more on wishful
thinking than compelling scientific data.

What about these
SPECT scans for all the other things that Dr. Amen treats? He
uses them in his diagnosis and treatment for many disorders:
attention deficit disorders (ADD), mood disorders, anxiety and
panic disorders, autistic spectrum disorders, obsessive
compulsive disorder (OCD), substance abuse, toxic exposure,
brain trauma, memory problems, temper problems, and relationship
and marital problems. Yes, he treats Alzheimer's and does
marriage counseling. That's a pretty wide playing field. Can
these scans really provide vital information about these
disorders and problems? Can they really provide valuable data
regarding appropriate treatment or counseling?

To answer these
questions, we must look at the control studies that have been
done to see how effective SPECT scans are in diagnosing various
brain disorders. Unfortunately,
the studies don't exist. We have to rely on Amen's
evaluation of his personal experience with thousands of scans
over many years. The self, however, is not exactly an unbiased
observer of personal experience. The potential for
self-deception here is enormous. A critical thinker would rather
see references to controlled studies than the self-serving
testimonials from satisfied customers that one finds on Dr.
Amen's website. No wonder one searches in vain to find Amen's
approach recommended by other psychiatrists. He truly is a voice
crying in the wilderness of his own making.

But, hey, Amen's been
featured on The
Today Show and The View, and I predict that in 2009 he will
get a spot on Oprah, thereby cementing his place in the annals
of woo along with Dr. Oz, Dr. Deepak Chopra, and psychic John Edward. Why wouldn't
Oprah have him on? After all, he's been on PBS.

update: It's now almost 4 years later (Nov 29, 2012) and PBS is still featuring an Amen infomercial during its fundraising. Amen has started exercising and he's encouraging others to do the same. Can't fault that, but he continues to integrate good health advice with nonsense. And Hamas continues to shell Israel, which responds with bombs of its own. Hmm. Hamas shells Israel, Israel responds, PBS uses an Amen informercial for fundraising. Coincidence?

further
information

"The cost of a
complete evaluation [at an Amen clinic] is $3,250.00 (includes
concentration and baseline scans). The patients will need to
allow 4 days of appointments, with each appointment running
approximately 1-2 hours/day. For patients outside of California,
a phone consultation is advised with one of the physician staff
to determine if the Clinic is the appropriate place for an
evaluation. A consultation by phone will cost $150.00 per half
hour." There's a 10% discount for each additional family member
being scanned. (Dr.
Amen's website, accessed January 1, 2009.)

In March and April
2008, "Change Your Brain, Change Your Life," another Amen
infomercial, "aired nearly 1,300 times on PBS stations across
the country, reaching more than 75 percent of U.S. television
households." (Salon.com)

PBS's latest infomercial by Robert Burton (By airing another
self-help show disguised as medical science -- the dubious "UltraMind
Solution" -- the public network continues to undermine its
credibility.)